Presurgical and postsurgical orthodontics are associated with superior secondary alveolar bone grafting outcomes.

INTRODUCTION: Despite the popularity and well-established procedures of secondary alveolar bone grafting (SABG), not all SABG surgeries are successful. To determine the factors related to SABG success, we investigated the radiographic outcomes of SABG and its association with a wide range of factors (e.g., demographics, surgeon, presurgical and postsurgical cleft status).

MATERIAL AND METHODS: Patients (N = 77, 9-12 years of age) with complete unilateral cleft lip and palate had been treated with SABG. Their postoperative cone-beam computed tomographic scans were analyzed for residual cleft defects, unsupported root ratio of central incisors and canines adjacent to clefts, and Bergland scale score. Possible influencing factors included sex, age, surgeon, presence of lateral incisor, canine eruption, cleft size, orthodontic treatment, postoperative infection, and duration of follow-up.

RESULTS: The oral cleft defect was associated with orthodontic treatment before (β = -119.1, p = 0.001) and after (β = -117.6, p < 0.01) surgery. The nasal cleft defect was associated with patient sex (β = 82.6, p < 0.05), which also predicted the unsupported root ratio of the central incisors (β = -0.04, p < 0.01). The Bergland scale score was associated with eruption status of the canines at surgery (odds ratio = 0.04, p < 0.01) and postoperative infection (odds ratio = 15.6, p < 0.05).

CONCLUSIONS: These results suggest that, in patients with unilateral cleft lip and palate, the radiographic outcomes of SABG are associated with patients' orthodontic treatment, eruption status of cleft-adjacent canines at surgery, postoperative infection, and sex.